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Respiratory > Microbiology > Flashcards

Microbiology Flashcards

1
Q

Give 3 symptoms of influenza

A
  • general malaise
  • myalgia headache
  • dry cough
  • prostration- extreme fatigue and weakness
  • fever
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2
Q

What are potential causes of classical flu?

A
  • Influenza type A and B viruses

- Influenza type C virus can also cause a form of influenza yet it is less common

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3
Q

How is flu spread?

A
  1. Droplets/ formites

2. Direct contact with respiratory secretions from an infected individual

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4
Q

How can influenza be treated?

A

Treatment can be:

  1. Symptomatic- bed rest, maintain fluids etc.
  2. Curative- antivirals such as oseltamivir and zanamivir
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5
Q

What allows influenza to cause frequent epidemics?

A

Antigenic drift- minor surface protein changes (usually)

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6
Q

Pandemics are potentially very dangerous when involving influenza- why?

A

Influenza A viruses only are involved. Antigenic shift occurs in an animal reservoir or mixing vessel. This means a “hybrid” virus can be formed that humans will have little if no immunity to

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7
Q

Which laboratory techniques can be used to determine the presence of the flu virus?

A
  • PCR- using nasopharyngeal swabs, throat swabs or other respiratory samples
  • Immunoflurescence for antigen detection
  • Viral cultures
  • Antibody detection
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8
Q

Influenza is prevented through vaccines, what is a “killed vaccine”?

A

The virus is grown in culture, inactivated and combined with an adjuvant- a substance to enhance immune reaction. This can be given annually to patients at risk of contraction, healthcare workers, the very young/old

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9
Q

Influenza is prevented through vaccines, what is an attenuated vaccine?

A

This is a more effective vaccine vs a killed vaccine. The real pathogen is used, but with reduced virulence. This vaccine is given to all children aged between 2 and 5

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10
Q

What is the most common cause of community acquired pneumonia?

A

Streptococcus pneumoniae

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11
Q

What are the three causes of atypical pneumonia?

A
  1. Mycoplasma pneumonia
  2. Legionella pneumonia
  3. Chlamydophilia pneumoniae
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12
Q

Coxiella burnetii is associated with which two main conditions?

A
  1. Q fever

2. Pneumonia

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13
Q

A complication, involving Q fever and the heart is likely to be what?

A 
Infective endocarditis
(caused by Coxiella burnetii)
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14
Q

Chlamydophila psittaci causes which condition?

A

Psittacosis

This is an uncommon sporadic zoonosis (pet birds) and will normally present as pneumonia

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15
Q

What is sporadic zoonosis?

A

An infectious disease from animals that can spread to humans

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16
Q

What is bronchiolitis?

A

A common lower respiratory tract infection causing inflammation of the bronchioles
It normally affects people in the first or second year of life
Grunting will occur- difficulty in breathing, reduced partial pressure of oxygen and sternal undrawing

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17
Q

What is most likely to cause bronchiolitis?

A

Respiratory syncytial virus (RSV)

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18
Q

What is metapneumovirus?

A

The second most common cause (after RSV) of lower respiratory infection in young children
The virus has highest incidence in winter

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19
Q

How is metapneumovirus disagnosed?

A

Throat swabs and PCR

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20
Q

What is chlamydia trachimatis?

A

A STI caused by bacteria
The bacteria can present in one of three ways:
1. Genitourinary
2. Pulmonary
3. Ocular
It can cause pneumonia in infants
Diagnosed by PCR on urine of mother, or perusal/ throat swabs of child

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21
Q

Coxiella burnetii is a bacteria mostly spread from what to humans?

A

Animals such as sheep or goats

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22
Q

When was metapneumovirus discovered?

A

2001

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23
Q

Name an alpha-haemolytic streptococci that can cause respiratory tract infection

A

strep pnemoniae

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24
Q

Name a beta haemolytic streptococci that can cause respiratory tract infection

A

strep pyogenes

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25
Q

Name two key gram negative bacteria that can cause respiratory tract infection

A
  1. Haemophilus influenzae

2. Moracella catharalis

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26
Q

What pathogen will cause acute epiglottitis?

A

Haemophilus influenza type B

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27
Q

What is used to test for the presence of haemophilus influenza in epiglottitis?

A

Blood culture

not throat swabs

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28
Q

What is the treatment for epiglottitis?

A

Ceftriaxone

29
Q

Haemophilus influenza will only grow on what?

A

Lysed blood agar

30
Q

Excerabations of COPD can be caused by which pathogens?

A
  • Haemophilus influenzae
  • Moraxella catarrhalis
  • Streptococcus pneumoniae
  • Gram negatives
31
Q

What is Moraella catarrhalis?

A

A gram- negative coccus bacteria commonly found in respiratory tract infection

32
Q

How can the cause of a COPD exacerbation be tested for?

A
  1. Sputum culture
  2. Sputum purulence
  3. CXR
33
Q

When will a COPD exacerbation be treated for infection?

A
  • When the sputum is purulent
  • When CXR changes
  • In the presence of pneumonia
34
Q

What is the first line treatment for infection during a COPD exacerbation?

A

Amoxcillin (500mg) for 5 days

(aims to treat H.influenzae, M.catrrhalis, S.pneumoniae

35
Q

What is the second line treatment for an infection during COPD exacerbation ?

A

Doxycycline 200mg on day 1 which drops down to 100mg between days 2 and 5

36
Q

By what other name is acute laryngotracheobronchitis known/

A

Croup

37
Q

Croup is characterised mainly by what?

A

Harsh cough and stridor

38
Q

How is croup treated?

A

Steroids

Humidification

39
Q

Coryza can be caused by which pathogens?

A

Rhinovirus -mainly

Coronavirus

40
Q

What is cystic fibrosis?

A

An inherited disease causing abnormally thick mucous blocking many tubular structures in the body (mostly lungs and digestive system)
This will lead to repeated chest infections and chronic infection because microbes become trapped

41
Q

What will often precede an episode of acute bronchitis?

A

UTI

whopping cough can cause the condition

42
Q

What is the clinical presentation of acute bronchitis?

A
  • Infection and inflammation of bronchi
  • Productive cough
  • Wheeze
  • Fever
  • Normal CXR
43
Q

What causes whopping cough?

A

Bordetella pertussis

44
Q

How does whopping cough present clinically?

A
  • Acute tracheobronchitis
  • Cold-like symptoms
  • Paroxysmal coughing (sudden recurrence/ worsening)
  • Repeated violent exhalations
  • Potentially vomiting
45
Q

How is Bortdetella pertussis diagnosed?

A
  • Bacterial culture - perusal swabbing and charcoal blood agar
  • PCR- perusal swab
  • Serology
46
Q

How does the treatment of whopping cough vary based on age?

A
  • Age <1 - clarithromycin
  • Age >1 - clarithromycin and azithromycin
  • Pregnancy- erythromycin
47
Q

Community acquired pneumonia is caused most frequently by which pathogen?

A

Strep pneumoniae

48
Q

How is pneumonia diagnosed?

A
  • Culturing sputum

- Undergoing viral PCR

49
Q

How is pneumonia treated?

A

Amoxicillin (5 days)
or
Co-amoxiclav and doxycycline (100mg)

Very severe:
Co-amoxiclav and IV clarithromycin

50
Q

How is pneumonia tested for?

A

Bloods

  • Erythrocyte sedimentation rate
  • C-reactive protein
  • Cultures

Sputum

  • Microscopy
  • Culture
  • Cytology
51
Q

Legionella pneumonia is known by which other name?

A

Legionnaire’s disease

52
Q

Legionella pneumonia is a form of _____ pneumonia

A

Atypical

53
Q

Where does the pathogen legionella pneumonia normally reside and how is it acquired?

A

Resides in water (stagnant) with water amoeba which provide nutrients and protection
Often acquired by coming into contact with this water (inhalation) or from direct person to person contact
Often acquired on holiday abroad

54
Q

What are some risk factors for Legionella pneumonia?

A
  • Coming into contact with contaminated water
  • Impaired immunity
  • Altered immunity
  • Diabetes
  • Smoking
  • Having a malignancy
55
Q

What is the treatment for legionella pneumonia ?

A

Clarithromycin and erythromycin
or
Quinolones such as levofloxacin

56
Q

What is the commonest causes for hospital acquired pneumonia?

A

Gram negative bacteri such as:

  • Klebsiella spp
  • Pseudomonas spp
  • E.coli

Clostridia (gram positive bacteria)
- staph aureus

57
Q

What is pneumocystis pneumonia and what causes it?

A

Pneumocystis jirovecii

58
Q

What is pneumocystis jiovecii and how is it acquired?

A

A fungus acquired through inhalation of spores

usually only affected severely immunocompromised- HIV etc

59
Q

How does pneumocystis jiovecii present clinically ?

A
  • Dry cough
  • Fever
  • Breathlessness
  • Fatigue
60
Q

How is pneumocystis jiovecii diagnosed?

A
  • Bronchoalveolar lavage
  • Sputum sample or gargle
  • Immunofluorescence (antibody techniques)
61
Q

What can be used as treatment for pneumocystis jirovecii?

A

Co- trimoxazole and prophylaxis

62
Q

What is aspergillus?

A

Aspergillus fumigateurs is a fungus that can cause severe pneumonia and invasive disease when inhaled in immunocompromised individuals
In normal patients localised pulmonary infection and potentially a aspergiloma (fungus ball) will develop

63
Q

How can aspergillus be diagnosed?

A

Bronchoalveolar lavage to obtain specimens for fungal culture and PCR
(tissue can also be examined)

64
Q

How is aspergillus fumigates treated?

A

Amphotericin B
Voriconazole
Surgery

65
Q

Tb is detected by which methods?

A
  • Culturing (most sensitive)
  • PCR
  • Ziehl- Neelsen stain (least sensitive)
66
Q

Describe how a Ziehl- Neelsen stain is performed

A
  • a red dye (carbol fuchsin) is added to a sample of Tb
  • the sample is heated slightly to melt the waxy coat of Tb
  • Alcohol and acid are then added and in mycobacteria the colour of the dye is still retained
  • A blue dye is then added (methylene blue)
  • If red dye is still visible under the microscope then Tb is present
67
Q

What are the pros and cons of a Ziehl- Neelsen stain?

A

Pros

  • cheap
  • fast

Cons

  • does not distinguish between species
  • Gives no information on drug sensitivity
68
Q

What are the pros and cons of PCR for Tb detection?

A

Pros

  • inexpensive
  • fast

Cons

  • little information on species
  • Little information pn drug sensitivity
69
Q

What are the pros and cons of culturing as a detection method for Tn?

A

Pros

  • highly sensitive and specific
  • Allows for information on drug sensitivity

Cons
-slow

Respiratory (12 decks)

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